Loga S, Curry S, Lader M
Clin Pharmacokinet. 1981 Nov-Dec;6(6):454-62. doi: 10.2165/00003088-198106060-00003.
Seven male inpatients suffering from acute schizophrenia were treated with chlorpromazine elixir 100mg 8-hourly for 9 weeks. Nortriptyline 50mg 8-hourly was added during weeks 4, 5 and 6. Plasma chlorpromazine concentrations, antipyrine plasma half-life, blood pressure, pulse rate, pupil size, salivation, handwriting and clinical state were measured at weekly intervals. Plasma chlorpromazine concentrations rose when nortriptyline was added, and the antipyrine plasma half-life was prolonged. Blood pressure dropped on institution of chlorpromazine and dropped further with the addition of nortriptyline. The pulse rate rose in a parallel fashion. Pupil size, salivation and handwriting were diminished by chlorpromazine, but hardly affected further by nortriptyline. The addition of nortriptyline dramatically reversed the therapeutic actions of chlorpromazine, mainly through pharmacodynamic interaction. It is concluded that this combination is potentially deleterious, and must be used with care.
7名男性急性精神分裂症住院患者接受了氯丙嗪酏剂治疗，剂量为100毫克，每8小时一次，持续9周。在第4、5和6周期间，加用了每8小时50毫克的去甲替林。每周测量血浆氯丙嗪浓度、安替比林血浆半衰期、血压、脉搏率、瞳孔大小、唾液分泌、笔迹和临床状态。加用去甲替林后血浆氯丙嗪浓度升高，安替比林血浆半衰期延长。使用氯丙嗪后血压下降，加用去甲替林后血压进一步下降。脉搏率以类似方式上升。氯丙嗪可使瞳孔大小、唾液分泌和笔迹减小，但去甲替林对其影响不大。加用去甲替林主要通过药效学相互作用显著逆转了氯丙嗪的治疗作用。结论是这种联合用药可能有害，必须谨慎使用。
